Zarmina Khan
Stray dogs have become a serious and growing concern in both rural and urban areas of Pakistan. While the dog is often regarded as a faithful companion and renowned for its guarding qualities, the unchecked population of stray dogs poses a serious public health and safety concern, especially through the deadly viral disease rabies. Thousands of dog-bite cases are reported annually in Pakistan. According to the Health Research Institute (HRI), almost 2,000 to 5,000 people die of rabies per year in Pakistan. In Sindh alone, more than 300,000 stray dog bite incidents were recorded in 2024, including several rabies-related deaths. A staggering 5,641 dog-bite cases were reported across Pakistan in just one week, according to the National Institute of Health (NIH) in July 2024. Punjab recorded the highest number with 3,264 cases, followed by Sindh with 1,601. Khyber Pakhtunkhwa reported 615 cases, Baluchistan 80, Azad Kashmir 75, and Gilgit-Baltistan 6. In just the first two months of 2025, more than 10,000 people in Pakistan were bitten by dogs. Nearly 8,000 dog-bite cases were reported from January 2025 at Civil Hospital Karachi (CHK), Jinnah Postgraduate Medical Centre (JPMC), and Indus Hospital, while almost six people died of rabies within just two months.
An 8-year-old boy was mauled to death by a pack of stray dogs in Vehari. The boy, Muhammad Arsalan, was walking home from his madrassa with two other children when the dogs attacked. While the other children managed to escape, Arsalan couldn’t get away and tragically lost his life before anyone could arrive to help. In February 2025, a man named Amir Shahzad died at Tehsil Headquarters (THQ) Hospital, Muridke, after being bitten by a stray dog 20 days earlier. His death reportedly occurred due to the unavailability of the rabies vaccine at the hospital. Residents claimed that at least 14 people had been bitten by stray dogs in a single day, but the hospital lacked the essential vaccines needed for timely post-bite treatment. Residents of Islamabad have urged the Capital Development Authority (CDA), Islamabad Metropolitan Corporation (IMC), and district health authorities to take immediate and coordinated action, as dog bite cases continue to surge day by day in the capital city.
To fully grasp this deadly disease, it’s important to consider a few key facts about rabies.
How does rabies persist in nature?
Why can’t we just get rid of it?
The rabies virus is primarily found in the saliva and nerve tissues, especially in the brain and spinal cord of mammals. It is not present in the blood, feces, or urine of infected animals. Once the virus reaches the brain and salivary glands, the animal becomes infectious. At this point, it can transmit the rabies virus to other mammals through a bite.
Rabies survives in wild animal populations known as reservoir hosts. These are species in which the rabies virus spreads naturally and often silently. Bats are considered the global reservoir of rabies. In Asia and Africa, common rabies reservoirs include dogs, jackals, mongooses, and bats. In North America, raccoons, foxes, skunks, and bats serve as reservoirs. In Latin America, the main reservoirs are vampire bats and dogs, while in Europe, foxes and bats are considered primary rabies reservoirs. These animals don’t always appear sick, which makes it difficult to detect infections and, therefore, it is hard to eliminate rabies. Rabies has a long incubation period (likely weeks to months), so an animal could carry this virus without looking sick. These animals move around, especially wild animals, and that’s how the virus spreads in the world. In developing countries, most of the stray dogs are not vaccinated and they live around humans. Therefore, when a rabid animal bites another animal, the virus in the saliva enters through the skin, travels through the nerves to the brain of that animal, multiplies, and then spreads back to the salivary glands. At that point, the rabid animal can spread the rabies virus to other mammals too. Once the symptoms appear, there is no cure for this fatal disease. If someone survives, it is quite rare and depends upon several factors, but the survival rate is extremely low.
Rabies is a fragile virus; it doesn’t survive on rocks, grass, in water, or in the air. It dies quickly outside the living body, especially in sunlight, heat, or dry conditions. Any mammal can get rabies through direct contact with the saliva, brain, or nervous tissues of a rabid animal, usually through a bite, but it can also be transmitted through a scratch if the infected animal’s saliva is on its claws. So, if a rabid bat bites a dog, the dog can get rabies. Then, if that rabid dog bites a human, the person can become infected too, even from a scratch, if the dog’s saliva is present on its claws. In humans, rabies symptoms usually appear weeks to months after exposure, depending on the location of the bite and the amount of virus introduced. Early symptoms include fever, headache, weakness or fatigue, and pain or tingling at the site of the bite or scratch.
Advanced symptoms include anxiety, confusion or agitation, hallucinations, difficulty swallowing (hydrophobia), excessive salivation, muscle spasms, paralysis, and coma.
Rabies symptoms in animals can vary, but they often involve behavioral changes and neurological signs. These may include sudden aggression or unusual friendliness, excessive drooling or foaming at the mouth, difficulty swallowing, staggering or lack of coordination, paralysis (especially of the hind legs or facial muscles), fear of water, and seizures.
Prevention of rabies virus involves two types of treatment: Pre-Exposure Prophylaxis (PrEP) and Post-Exposure Prophylaxis (PEP).
PrEP is given to people at high risk, such as veterinarians or people living in areas with high rabies incidence, as a preventive measure before any exposure. PEP should be administered as soon as possible after a dog bite or scratch, ideally within 24 hours. Delaying treatment increases the risk, as rabies is almost always fatal once symptoms appear. It involves immediate wound cleaning with antiseptic, followed by a series of rabies vaccination doses, and the administration of Rabies Immunoglobulin (RIG), especially when the animal is suspected or confirmed to be rabid, or the attack is severe. Although PrEP builds immunity before infection, PEP is critical to prevent the disease after exposure.
There are some Myths about Rabies, which are needed to be addressed.
A dog can get rabies by eating a snake. This is not true; mostly, the rabies virus spreads through warm-blooded mammals like monkeys, foxes, coyotes, dogs, cats, bats, and humans. Cold-blooded animals such as snakes, lizards, frogs, and fish are not susceptible to the rabies virus, and therefore, they cannot carry or transmit the disease.
One of the prominent factors behind this is temperature. The rabies virus needs a specific environment to stay alive and multiply, and this environment is primarily found in the nervous system of mammals. The warm temperature of these mammals helps the virus to multiply in their bodies. According to the Centers for Disease Control and Prevention (CDC), rabid dogs are responsible for 90% of rabies exposures worldwide, and these exposures account for 99% of all human rabies deaths.
Animals with rabies always foam at the mouth. This is a common misconception. Hypersalivation occurs only in some cases and typically indicates the late stages of the disease. Sometimes, animals just appear weak, aggressive, or even overly friendly.
A vaccinated dog cannot get rabies. The belief that a vaccinated dog cannot get rabies is a fallacy. While the rabies vaccine is highly effective and significantly reduces the risk of infection, it does not offer 100% protection. Therefore, if a dog shows any signs of rabies, the owner should immediately consult a veterinarian.
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